RESUMEN
Study of the function of the hypothalamopituitary system in patients with hypogonadotrophic amenorrhea showed the activity of its structures which manifested by the presence of pulsed LH secretion in 70% of women; however, the parameters of pulsed secretion of gonadotropins were disordered: the pulses were chaotic and low-amplitude. Adenohypophyseal gonadotrophs were capable of reacting to the administered gonadotrophin-releasing hormone, but the parameters of this reaction differed from the normal. The endocrine status of patients with hypogonadotrophic amenorrhea was changed vs. that in health: prolactin level was reduced, growth hormone level increased, thyroid and adrenocortical function changed; the pattern of secretion of some adenohypophyseal trophic hormones (prolactin, STH, TTH) was also changed. The results permit a hypothesis that impairment of the common central mechanisms regulating the endocrine system underlies the development of this disease; basing on their findings, the authors propose new approaches to the correction of this abnormality.
Asunto(s)
Amenorrea/fisiopatología , Glándulas Endocrinas/fisiopatología , Sistema Hipotálamo-Hipofisario/fisiopatología , Adulto , Amenorrea/sangre , Amenorrea/terapia , Dexametasona/uso terapéutico , Femenino , Hormona Liberadora de Gonadotropina/uso terapéutico , Humanos , Hidrocortisona/sangre , Hormona Luteinizante/sangre , Prolactina/sangre , Hormonas Tiroideas/sangreRESUMEN
Clinico-hormonal parameters of cycles stimulated with human menopausal gonadotropins in patients with hypogonadotropic amenorrhea and of spontaneous cycles in healthy women of reproductive age are compared. Estradiol hypersecretion in both phases of induced cycle was revealed: hydrocortisone in phase 1 and progesterone and testosterone in phase 2. Dexamethasone in daily dose 0.25 mg was administered for correction. This resulted in a noticeable reduction of estradiol hyperproduction in the first phase of stimulated cycles and in hyperandrogenism elimination. Folliculogenesis, ovulation, and early embryogenesis conditions in schemes of induction with human menopausal gonadotropins and dexamethasone therapy were close to physiologic ones, this resulting in increased share of fertile cycles.
Asunto(s)
Amenorrea/tratamiento farmacológico , Genitales Femeninos/fisiopatología , Gonadotropinas/deficiencia , Menotropinas/uso terapéutico , Inducción de la Ovulación/métodos , Adulto , Amenorrea/etiología , Amenorrea/fisiopatología , Femenino , Genitales Femeninos/efectos de los fármacos , HumanosRESUMEN
Forty-three ovulation cycles stimulated with human menopausal gonadotropin were examined in 31 patients with hypogonadotropic amenorrhea. Peripheral blood estradiol and luteinizing hormone were radioimmunoassayed. The findings indicate the possibility of recovery of adenohypophyseal gonadotropin autosecretion in the presence of human menopausal gonadotropin administration.